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Mental Health in the Headlines: Week of March 24, 2014

Week of March 24, 2014

Mental Health in the Headlines is a weekly newsletter providing the latest developments at Mental Health America and summaries of news, views and research in the mental health field. Coverage of news items in this publication does not represent Mental Health America’s support for or opposition to the stories summarized or the views they express.

March 31 ACA Enrollment Deadline: The enrollment period for individual and small group policies offered through the Affordable Care Act will expire at the end of this month. There are a number of resources available to help consumers understand the options available to them:

Enroll America’s website Get Covered provides information for consumers on their coverage options under the law. Learn how to get local enrollment help and more.

The National Health Council has launched a website, Putting Patients First, to help patients estimate their insurance costs and pick the right exchange plan. PPF’s Cost Estimator tool allows anyone to enter their general medical information (such as how many doc visits they anticipate in the next year, regular medications, income level, etc.) and guides them to the specific plan level best suited for them to ensure the most coverage possible with the lowest out-of-pocket costs.

The Substance Abuse and Mental Health Services Administration has released a training resource toolkit, developed through the Enrollment Coalitions Initiative, entitled “Getting Ready for the Health Insurance Marketplace.” The toolkit provides an understanding of the health care law and how individuals with lived experience of mental health labels and histories might benefit from it. It also provides information on how the Health Insurance Marketplace works in order to make it easier to obtain the health coverage that meets each individual's needs.

Mental Health America Capitol Hill Day—May 7: Mental Health America is partnering with the National Council for Behavioral Health for Capitol Hill Day ’14 on May 7—the biggest behavioral health advocacy event of the year. This year, Hill Day will be held in conjunction with the National Council’s 2014 Conference, which is taking place at the Gaylord National Resort and Convention Center just outside of Washington, DC. Registration for Hill Day is free and includes and Public Policy Track sessions and workshops held on May 6, including leadership lessons from Former Secretary of State Hillary Rodham Clinton. For more information on hotel accommodations, a schedule and to register, go to http://www.thenationalcouncil.org/events-and-training/hill-day/register-book/.

IN THE NEWS

Administration Expected to Allow Some People to Enroll for Health Coverage after March 31 Deadline: The Obama administration is expected to issue guidelines allowing people to enroll in health coverage after a March 31 deadline, but only under certain circumstances. According to sources, the new federal guidelines for consumers in the 36 states served by the federal health insurance marketplace and its website, HealthCare.gov, would allow people to enroll after March 31 if they had tried earlier and were prevented by system problems including technical glitches. On Friday, the administration published in the Federal Register new regulations that would allow state-run marketplaces new flexibility in setting insurance coverage effective dates for people who sign up during special enrollment periods. The U.S. Department of Health and Human Services (HHS) could not confirm whether an announcement was expected soon but said the administration would not neglect people who have problems enrolling. (Reuters, 3/24/14)

Mindfulness Helps Prevent Drug, Alcohol Relapse—Study: A treatment program incorporating mindfulness meditation is better over the long term than traditional approaches at preventing relapses of drug and alcohol use, according to a new study. Researchers found that after one year far fewer participants who got relapse-prevention training, including mindfulness techniques, had used drugs or alcohol compared to those given relapse-prevention therapy alone or a standard 12-step program. Although they cautioned that mindfulness is not better for everyone, they said it is another option. Reported in the journal JAMA Psychiatry, the study recruited 286 people who had successfully completed substance use treatment and randomly assigned them to participate in one of three treatments for eight weeks. One group did a standard 12-step program, another group did a cognitive-behavioral-based relapse prevention program and the third group did a program combining relapse-prevention with mindfulness techniques. The researchers then followed the participants for 12 months to see how many used drugs or alcohol. After another three months, both of the relapse-prevention groups began performing better than the 12-step program participants. At the one-year mark, the mindfulness-based relapse-prevention therapy outperformed the other two approaches. About 9 percent of the participants in the mindfulness group reported drug use after a year, compared to about 14 percent in the 12-step program group and 17 percent in the traditional relapse-prevention group. Only about 8 percent of the participants in the mindfulness group also reported heavy drinking after a year, compared to about 20 percent in the other two therapy groups. (Reuters, 3/20/14)

New Research Links Depression, Obesity in Teen Girls: New research finds that adolescent females who experience either obesity or depression are at a greater risk for the other as they get older. By assessing a statewide sample of more than 1,500 males and females in Minnesota over a period of more than 10 years, researchers found that depression occurring by early adolescence in females predicts obesity by late adolescence. Meanwhile, obesity that occurs by late adolescence in females predicts the onset of depression by early adulthood. No significant associations between the two disorders across time were found in males during the study. The study improves on past research by focusing on the onset of each disorder, rather than just recurrence or persistence of the two conditions. Participants in the study, which was published in the International Journal of Obesity, were assessed at ages 11, 14, 17, 20, and 24 by using height and weight measurements and clinical, interview-based diagnosis of major depressive disorder. The researchers looked specifically for onsets of either disorder by age 14, between the ages of 14 and 20, and between ages 20 and 24. (Newsworks.org, 3/20/14)

Children in Military Families Who Relocate at Increased Risk of Mental Health Difficulties: Children in military families who relocate have an increased risk of having mental health difficulties, according to a new study. Reported in the Journal of Adolescent Health, the study used medical records from the Military Health System Medical Data Repository of more than half a million children of active duty U.S. service personnel in 2008. The study controlled for factors such as the mental health of the parents and the branch of service and rank of the military parent. About 25 percent of the 548,366 children of military parents involved in the study relocated. The actual number of children of all military personnel who moved during that year is higher, since the lower age cut-off was age 6. The military children who moved in 2008 were significantly more likely to have a mental health care visit in 2009 than military children who did not move. This was true for outpatient visits, emergency room visits and psychiatric hospitalization. Adolescents who moved had more severe mental health issues than younger children. (Medical Xpress, 3/21/14)

Integrating Mental Health Care in Pediatric Practice Effective—Study: Brief behavioral and mental health programs for children can be effectively provided within pediatric practices as an alternative to being referred to a community specialist, according to a randomized trial. Reporting in the journal Pediatrics, researchers found that treatment provided in the pediatrician's office resulted in improved access to care, greater participation by both the child and their caregiver in treatment programs, and higher rates of treatment completion, without burdening the pediatric practice. The study recruited 300 children and their caregivers at eight community pediatric practices who had been referred for treatment of behavioral problems, though many also had attention-deficit/hyperactivity disorder (ADHD) or anxiety. Half the children received "doctor office collaborative care," where a trained behavioral health clinician, known as a care manager, collaborated with the child's pediatrician to deliver mental health services in the pediatrician's office. The other half received "enhanced usual care," where the patients received educational materials and were referred to a local mental health specialist outside the pediatrician's office. In the program at the pediatrician's office, the child and their caregiver participated in six to 12 individual or family sessions within six months where the mental health clinician worked on individualized goals to address the behavioral health issue and reviewed educational materials to help achieve those goals. Of the participants assigned to the care manager at the pediatrician's office, 99.4 percent began treatment programs and 76.6 percent completed them. Of those assigned to a specialist outside the office, 54.2 percent began treatment and 11.6 percent completed it. The program in the pediatrician's office also was associated with higher rates of improvement in behavioral and hyperactivity problems, lowered parental stress, better treatment response and consumer satisfaction. (Pittsburgh Post-Gazette, 3/24/14)

ICU Patients Face Risk of Mental Health Problems after Discharge: Critically ill people who survive a stay in the intensive care unit face a heightened risk of mental health problems in the months after hospital discharge, a new study suggest. In looking at more than 24,000 Danish ICU patients, researchers found that after discharge, people had an increased risk of developing depression, anxiety disorders or other psychiatric conditions. Although the rates weren’t high—about 0.5 percent of patients had a new diagnosis in the three months post-discharge—it was 22 times the rate seen in the general population over the same time period. Reported in the Journal of the American Medical Association, the study highlights what researchers say is an emerging issue: As doctors get better at saving the lives of critically ill patients, more people will be at risk of longer-term problems beyond general health. For the study, the researchers used records from Denmark's system of medical databases. Of the 24,000 ICU patients who were ill enough to be placed on a ventilator for complications ranging from lung failure to life-threatening infections, almost 10,000 had no diagnosis of a mental health condition, or prescription for psychiatric drugs, in the prior five years. But in the three months after their discharge from the ICU, 0.5 percent received a new diagnosis, the researchers noted. Most often, that meant an anxiety disorder or "mood" disorder such as depression. Many more—13 percent—received a new prescription for a psychiatric medication, including antidepressants and drugs for anxiety and insomnia, according to the report. Those rates were much higher than the ones among more than 80,000 Danish adults matched to the ICU patients for age and sex. Over the same time period, there were 0.02 percent diagnosed with a mental health condition, and 0.7 percent were prescribed a psychiatric drug. The ICU patients' risks also exceeded those of other hospital patients who didn't need intensive care. In that group, the study found, 0.2 percent that were diagnosed with a psychiatric disorder in the three months after discharge, and 5 percent were prescribed a drug. Although the ICU patients had a higher rate of past mental health conditions, that didn't explain the post-discharge risks seen in the nearly 10,000 ICU patients with no signs of past mental health problems. (HealthDay News, 3/18/14)

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